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Cenobamate (CNB) use in epilepsy patients is linked to significant unintentional weight loss in a notable number of individuals. Dose reduction may reverse this effect without worsening seizures.

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Area of Science:

  • Neurology
  • Clinical Pharmacology

Background:

  • Limited data exists on weight changes associated with Cenobamate (CNB).
  • Concerns regarding clinically significant weight loss prompted this case-control study.

Purpose of the Study:

  • To evaluate weight changes in patients with epilepsy treated with Cenobamate.
  • To assess the incidence and potential reversibility of weight loss associated with CNB.

Main Methods:

  • A case-control study evaluated 118 epilepsy patients with at least 180 days of CNB exposure.
  • Baseline weight, trough, and peak weights during CNB treatment were recorded.
  • Concomitant antiseizure medications (ASMs) were also documented.

Main Results:

  • 27.8% of patients experienced at least 10% weight loss; 5.1% had ≥20% weight loss.
  • Higher CNB doses (≥200 mg/d) were associated with greater weight loss.
  • Weight loss effects appeared reversible with dose reduction in some patients, without seizure exacerbation.

Conclusions:

  • A significant number of patients experienced unintentional weight loss with CNB use.
  • Weight loss may be reversible with CNB dose reduction.
  • Systematic weight monitoring is recommended for all patients on CNB, with consideration for dose adjustment if excessive weight loss occurs.